1. Appointments summary Lawley Medical Practice 02Nov15

2. Room / Clinical staff availability 7 Clinical rooms in practice used by GPs, ANP, Nurses, Health Care Assistant, Counsellors, Midwives, Phlebotomist and others Meeting room in practice used daily by Duty Doctor for phone calls Rooms in use from 8am – 6pm (and to 8pm on Mondays) 1 upstairs clinical room free one morning/one afternoon all week – otherwise no rooms free

3. No of appointments/DNAs In June 15 1864 GP appointments booked 81 appointments not attended (4% DNA) 892 Nursing appointments booked 56 appointments not attended (6% DNA) Total of 137/2756 not attended overall (5%)

4. No of appointments In June 15 – 1864 appointments 869 Routine GP appointments (booked ahead) 512 Book on Day GP appointments 340 GP booked 62 ‘Other’ book (Womens health/Minor Op) Also: 820 GP phone calls (341 routine/479 urgent) Total of 2684 GP consultations/ 3576 overall

5. No of appointments/DNAs In Oct 15 (to 29Oct) 1714 GP appointments booked 105 appointments not attended (6.1% DNA) 2024 Nursing appointments booked 77 appointments not attended (3.8% DNA) (1108 routine, 565 Flu, 154 GP booked, 151 Phlebotomry, 46 health checks) Total of 182/3738 not attended overall (4.8%)

6. No of appointments In Oct – 1714 appointments 1155 Routine GP appointments (booked ahead) 0 Book on Day appointments 463 GP booked 73 ‘Other’ book (Womens health/Minor Op) Also: 1320 GP phone calls (all on the day) Total of 3034 GP consultations/ 5058 overall

7. Our conclusions of change The change to the triage system has meant: More efficient use of GP time as ‘on the day’ appointments given now by GP are ‘on the day’ needs – Example – sick note request sent as task not seen – Example – minor injury may now have advice, may be sent directly to A&E for Xray, may be seen Majority of patients seem to prefer it More routine appointments also

8. What might we expect to see? National average is 6 consultations per year with clinical staff for each ‘average’ patient 8,500 patients= 51000 per year = 4250 monthly In Oct 15: 3035 GPs, 1459 Nursing(minus flu) so 4494 offered, so we are offering more than this BUT we also are below ‘average’ as our weighted patient number are around 7,000 patients so should be lower than this at 3,500 per month, but is actually higher…….

9. Other workload pressures 24% increase in GP consultations in past 14 years since 1998 (data from report Jan14) 90% of all NHS contacts occur in general practice The ‘average’ member of public consults with the GP 6 times a year (doubled from previous 10 years) 53% of patients report living with a chronic condition, majority managed by GPs GP income is declining in real terms (11% decline since 2008). Costs of running practice have increased by 2.3% in this time(building/staff costs)

10. Other work As noted in our Day in a Life of a GP. GPs also need to do other clinical/admin work: Patients: prescription requests/ review patient results/ review patient letters from hospitals/deal with patient requests/ review patient ‘target’ data / write reports Attend practice/commissioning meetings Have training as needed Run a business

11. Our current challenge – Winter 2015 Appointment requests rise in winter nationally Home visits numbers rise in winter for elderly Duty GPs are working continuously from 8am to 6pm to deal with phone triage (apart from Weds when we have emergency calls only from 12.10- 2.10) Concern that putting home visits and other work such as prescriptions/tasks at risk in winter Concern of Duty Doctor fatigue from triage calls

12. Proposal To put in some more protected time for GPs each day when we have emergency calls only This would not change the amount of work, but would makes it safer for Duty Doctor to handle the home visit requests and the emergency calls (we have emergency phone line for lunchtime Weds calls)